Norfolk D R, Bowen M, Cooper E H, Robinson E A
Br J Haematol. 1985 Dec;61(4):641-7. doi: 10.1111/j.1365-2141.1985.tb02878.x.
Changes in plasma levels of the opsonic glycoprotein fibronectin were studied during machine apheresis in 32 healthy plasma donors and 18 patients undergoing a total of 86 therapeutic plasma exchanges. Donation of 500 ml of plasma at 3-monthly intervals produced a 10% immediate decrease in plasma fibronectin with no evidence of a long-term affect on levels of this protein. One plasma volume exchange with fibronectin-poor plasma protein fraction produced subnormal plasma fibronectin levels in 98% of post-exchange samples. Efficiency of exchange was significantly lower in patients with paraproteinaemia, probably reflecting increased plasma volume in such patients. Daily plasma exchange produced progressive depletion of plasma fibronectin (index of recovery 0.68) whereas levels were maintained close to the initial value with longer exchange intervals, except in the more severely ill patients. Reduction of plasma fibronectin by plasma exchange may increase susceptibility to infection and reduce the efficacy of this procedure when the object of exchange is to reverse reticuloendothelial blockade.
在32名健康血浆捐献者以及18名总共接受了86次治疗性血浆置换的患者进行机器单采血浆术期间，对调理素糖蛋白纤连蛋白的血浆水平变化进行了研究。每3个月捐献500毫升血浆会使血浆纤连蛋白立即下降10%，且没有证据表明对该蛋白水平有长期影响。用缺乏纤连蛋白的血浆蛋白组分进行一次血浆量置换后，98%的置换后样本中血浆纤连蛋白水平低于正常。在副蛋白血症患者中，置换效率显著较低，这可能反映了此类患者血浆量增加。每日进行血浆置换会导致血浆纤连蛋白逐渐消耗（恢复指数为0.68），而除病情较重的患者外，较长的置换间隔可使血浆纤连蛋白水平维持在接近初始值的水平。当血浆置换的目的是逆转网状内皮系统阻滞时，通过血浆置换降低血浆纤连蛋白水平可能会增加感染易感性并降低该治疗方法的疗效。
